Feedback Can Be Less Stressful: Medical Trainee Perceptions of Using the Prepare to ADAPT (Ask-Discuss-Ask-Plan Together) Framework

Abstract

Introduction

Meaningful feedback is essential for effective medical education, yet the feedback process has been consistently problematic for both learners and faculty. Emerging research on feedback highlights the importance of the learner, relationships, and culture for feedback to improve performance. We used the theory of self-regulated learning to develop the Prepare to Ask-Discuss-Ask-Plan Together (Prepare to ADAPT) framework to improve the feedback processes and investigated learner perceptions of this innovative feedback framework.

Methods

Qualitative thematic analysis of structured interviews of nine trainees participating in training on the Prepare to ADAPT feedback framework.

Results 

The framework appeared primarily to potentially decrease learner anxiety and stress around the feedback process by providing a simple, structured discourse pattern. We identified five contributing themes: (1) increased efficiency of the feedback process; (2) formation of coaching/teamwork relationships; (3) facilitation of reflection and goal identification; (4) increased frequency of the feedback; (5) increased usefulness of the feedback.

Discussion

The Prepare to ADAPT framework may help decrease stress and anxiety of the feedback by clarifying the process, applying a structure, and developing coaching relationships. The framework was found to be easy to use and increased the number of effective feedback conversations in this exploratory study.